Ashley woke up at 5 a.m. and stepped on the scale, which today read 103. “I just have four more pounds to go until I am in the double digits,” she thinks. “So I’ll run for one hour this morning, I’ll skip breakfast, and I will only have a small salad for lunch. Then after school, I will do 200 burpees, 100 lunges and will walk for another hour. Then, just maybe, I will lose some more weight.”

For the 5’4” sophomore, this was her daily morning routine, motivated by a time when a guy at school teased her by calling her “Assy Ashley.” From that moment, all Ashley could do was criticize her physical appearance, spending hours in front of the mirror each day. During her runs, she envisioned her perfect self, who was thin to the point that her hip bones jutted out. “Then,” she thought, “I will make Matt so jealous, that he will be sorry that he said that. I will be able to walk away from him knowing that I got back at him.”

This is a mere fraction of many people’s thought processes when they struggle with eating disorders, no matter their age. Criticism, negativity and self-loathing permeate their thoughts, and their need for acceptance is taken to a whole other level: obsession. One base belief is, “If I am perfect, then I am loveable. Otherwise, I’m nothing.” Unfortunately, even with an amazing support system, this belief can remain for most of their lives.

If you or a loved one (male or female) exhibit thoughts or behaviors similar to Ashley, or if you identify with a combination of the signs listed below, it may be time to seek support for an eating disorder:

Obsessing, whether out loud or in thought, about weight, food, the latest diet or working out

Weighing multiple times per day, with a resulting change in attitude or mood

Making up excuses for not eating when hungry or lying about being hungry (e.g., I’m not hungry, I’ve already eaten, I’m not feeling well)

Leaving the table after eating, which may indicate purging behaviors

Eating, potentially to excess, on one day but not eating the next

Exercising to extremes (though this may not be the case if the person is a high-level athlete)